Severe underfunding, lack of access to care jeopardise at-risk TB populations
More people received life-saving treatment for tuberculosis (TB) in 2018 than ever before, largely due to improved detection and diagnosis. Globally, 7 million people were diagnosed and treated for TB - up from 6.4 million in 2017 – enabling the world to meet one of the milestones towards the United Nations political declaration targets on TB.
World Health Organisation's (WHO) latest Global TB Report says that 2018 also saw a reduction in the number of TB deaths: 1.5 million people died from TB in 2018, down from 1.6 million in 2017. The number of new cases of TB has been declining steadily in recent years. However, the burden remains high among low-income and marginalised populations: around 10 million people developed TB in 2018.
The role of Universal Coverage
In many countries today, fragile health infrastructure and workforce shortages make it difficult to provide timely diagnosis and the right treatments for TB. Weak reporting systems are another problem: health providers may treat people but fail to report cases to national authorities, leaving an incomplete picture of national epidemics and service needs. Further, up to 80% of TB patients in high burden countries spend more than 20% of their annual household income on treating the disease.
One way to improve coverage is to adopt more people-centred comprehensive approaches. Better integrated HIV and TB programmes already mean that two thirds of people diagnosed with TB now know their HIV status. In addition, more people living with HIV are taking treatment.
Tackling drug resistance
Drug resistance remains another impediment to ending TB. In 2018, there were an estimated half a million new cases of drug-resistant TB. Only one in three of these people was enrolled in treatment.
New WHO guidance aims to improve treatment of multidrug resistant TB, by shifting to fully oral regimens that are safer and more effective. The guidance is part of a larger package of steps released on 24 March 2019 - World TB Day - to help countries speed up efforts to end the disease.
Funding
The fight against TB remains chronically underfunded. WHO estimates the shortfall for TB prevention and care in 2019 at US$3.3 billion. International funding (which is critical for many low- and middle-income countries) amounts to US$0.9 billion in 2019, with 73% coming through the Global Fund. Last week's successful replenishment of the Global Fund will be critical to strengthen international financing.
There is an urgent need for funding of TB research and development, with an annual shortfall of US$1.2 billion. Priority needs include a new vaccine or effective preventive drug treatment; rapid point-of-care diagnostic tests; and safer, simpler, shorter drug regimens to treat TB.
Source: World Health Organisation